Orificial instrument construction



July 28, 1959 w. c. MOORE ORIFICIAL INSTRUMENT CONSTRUCTION Filed Aug. 8, 1957 item INVENTDR. \A/\\.|.\AM C. Moon:

" (m-umgw United States ()RIFICIAL INSTRUlVIENT CONSTRUCTION 7 Claims. (Cl. 128 -3) This invention relates generally to medical instruments of the class employed for examination of body cavities, and has particular reference to a novel construction for instruments such as anoscopes, rectoscopes, proctoscopes, sigmoidoscopes, and the like.

The invention is preferably embodied in an electrically illuminated diagnostic instrument of the aforementioned type wherein the speculum of the instrument, in addition to being open at both ends, is formed with a relatively wide, longitudinally extending slot or cut-away area which enables the examining physician to view a portion of the cavity wall adjacent the side of the speculum as well as the area adjacent the distal end thereof. In or der to enable examination of all portions of the cavity wall without the necessity of rotating the entire instrument, the speculum is rotatable relative to the speculum holder and instrument handle and, in accordance with the invention, rotation is efiected by a conveniently located control element adjacent the proximal end of the instrument which can be actuated without obstructing the physicians view as he looks into the speculum. This arrangement is a substantial improvement over conventional instruments of this type wherein the speculum is fixed relative to the handle and, in order to rotate the speculum, the handle must also be rotated which is difficult in the case of a rectal examination and frequently causes discomfort to the patient.

In addition to being rotatably mounted relative to the speculum holder and instrument handle, the speculum can also be completely disengaged from the remainder of the instrument which enables more eflicient sterilization of the parts after use and, in the case of electrically illuminated instruments, eliminates the necessity of sterilizing illuminating components of the instrument which do not normally come into contact with the patient. releasably securing the speculum to the speculum holder is the same as the rotation eifecting means for the speculum, whereby a simple yet very practical arrangement is provided as will be explained in detail hereinafter. i

With the foregoing and other considerations in view, therefore, it may be stated that the primary object of the present invention is to provide a greatly improved construction for orificial instruments wherein the speculum of the instrument is rotatably mounted relative to theremainder thereof and also is completely disengageable therefrom.

Another important object of the invention is to provide an instrument of the above described type wherein the speculum can be rotated relative to the remainder of the instrument while the physician is looking into the speculum without in any way obstructing his view.

Still another important object of the invention is to provide an instrument of the above described type having an actuating means for eflfecting rotation of the spec- In accordance with the invention, the means for attent speculum to the remainder of the instrument.

A further important object of the invention is to provide an instrument of the above described type which is relatively simple in construction and yet is strong, durable and efficient in operation.

Other objects and advantages of the invention will become apparent from the following detailed description thereof read in conjunction with the accompanying drawings which illustrate a representative embodiment 'of the invention for the purpose of disclosure.

In the drawings:

Figure 1 is a side elevation of the upper portion of an orificial instrument embodying the invention;

Figure 2 is a top plan view of the speculum of the instrument shown in Figure 1; and

Figure 3 is a vertical section through the upper portion of the instrument taken on a substantially centrally disposed, longitudinally extending plane.

Having reference now to the drawings, wherein like reference numbers designate the same part in each of the views, and wherein the invention is shown as applied to an anoscope, the instrument is essentially comprised of a conventional battery handle 5,'light carrier 7, speculum holder 8 and speculum 10. Also provided with the instrument, but forming no part of this invention, is an obturator 11 (shown in phantom lines in Figure 1) which is positioned within the speculum when the in strurnent is inserted into the body cavity to form with the speculum a relatively smooth, tapered entering portion. After the speculum has been fully inserted in the cavity, the obturator is removed by means of a knob or handle 12 at the proximal end thereof which pennits the physician to look through the speculum with the aid of a small lamp 14 mounted on the light carrier, the latter being electrically connected to the battery handle in the usual manner.

The speculum holder 8 is rigidly yet releasably mounted on the light carrier 7 and is formed at its upper end with a ring shaped portion 15 in which a ring shaped portion 17 of the speculum 10 is telescopically received. The speculum is open at both ends as is best shown in Figure 3, and the body entering portion 18 thereof is flared outwardly as at 20 adjacent its proximal end to merge with the ring portion 17. In addition to being open at its ends, the speculum is formed with a relatively wide, longitudinally extending slot or cut-away portion 21 so that the body entering portion thereof is substantially U-shaped. This configuration enables the physician to view a portion of the cavity wall adjacent the side of the speculum as well as the area adjacent the distal end thereof. Rotation of the speculum while inserted in the cavity will therefore enable the physician to examine the entire cavity wall and, to prevent injury to the tissues as the speculum is being rotated, its edges are rolled or rounded as indicated at 22. v

The ring'portion 17 of the speculum can be quickly disassembled from the ring portion 15 of the speculum holder in a manner to be presently described, and in reassembling the parts the speculum is inserted into the holder from the front or distal side thereof, a substantially semi-annular flange 24 on the speculum preventing insertion from the opposite direction. When the flange 24 abuts against the front edge of the holder ring 15, the rear or proximal end of the speculum ring projects beyond the rear edge thereof, as best shown in Figures 1 and 3, and the flange provides a guide bearing surface as the speculum is rotated relative to the holder.

The speculum ring portion 17 is formed'with a centrally disposed annular channel 25, Figures 2 and 3, having teeth 27 formed in the rear side wall thereof Patented July 28, 1959 whereby an annular rack is provided on the speculum in a plane perpendicular to the longitudinal axis thereof. The teeth 27 are adapted to be engaged by a pinion 28 fixed to the inner end of a stem or plunger 30 mounted in a hollow'boss 31 on the speculum holder. In the illustrated embodiment of the invention, this'boss is located at the top of the speculum holder and the chamber 32 within the boss communicates with a radial bore 3?; through the holder ring portion 15. The pinion 28 1s partially positioned in this bore and is normally biased intoenga'gement with the rack on the speculum by means of a compression spring 34 encircling the stem 30 between the top of the chamber 32'and a Washer 35 resting on the pinion.

At its upper end, above the boss 31, the stem St is fixed to a knurled knob 37 and it will be apparent therefore that when this knob is turned, the pinion will coact with the teeth 27 on the speculum to effect rotation of the latter in either direction through 360 or more. To assist the flange 24 in guiding this rotation, the stem projects a short distance below the pinion and'is received in a narrow sub-channel 38 formed centrally in the speculum channel 25. Since the pinion 28 normally projects into the speculum channel 25 due to the spring 34, it also serves as a releasable means to secure the parts together. However, when it is desired to separate the speculum from the holder, the knob 30 is simply pulled radially outwardly against the action of the compression spring which withdraws the pinion all the Way into the bore 33 and permits disengagement of the speculum by lengthwise movernent thereof relative to the remainder of the instrument.

In using the construction just described, the examining physician can hold the instrument handle in a fixed position with one hand and rotate the speculiun by means of knob 37 with his other hand While he is looking through the speculum. Moreover, due to the. location of the knob adjacent the proximal end of the instrument and on the outside of the speculum holder, the rotation can be elfe'cted without interfering with or in any way obstructing the physicians view. Since this same conveniently located rotation elfecting means also operates to releasably secure the speculum and holder together, as described hereinabove, a very practical and convenient arrangement is provided without unduly complicating the structure of the instrument. Thus, after he has completed his examination, the physician needs only to pull outwardly on the knob 37 and the parts can be quickly disassembled to insure thorough sterilization of every portion thereof. The quick and easy manner of disengaging the parts is also advantageous, of course, in enabling interchangeable use of specula of various sizes with a single support assembly.

The invention may be embodied in other specific forms Without departing from the spirit or essenial characteristics thereof. The embodiment disclosed is therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims.

What is claimed is:

1. In a diagnostic instrument for the examination of a body cavity, a substantially tubular speculum adapted to enter the cavity, said speculum being open at both ends with a closed ring portion adjacent the proximal end, a holder for said speculum having a ring portion telescopically engageable with said speculum ring portion, and means on said holder and engageable with said speculum ring portion to effect rotation of the latter, said rotation effecting means also acting to releasably hold said two ring portions in engagement with one another.

2. In a'diagnostic instrument for the examination of'a body cavity, a speculum holder, an open ended substantially tubular speculum rotatably mounted in said speculum holder, and means to rotate said speculum relative to said holder comprising an annular rack on said speculum and a pinion on said holder normally in mesh with said rack, said speculum and said holder being so shaped that said pinion, when in mesh with said rack, holds the speculum and holder in assembled condition, said pinion being movable out of mesh with the rack to permit separation of said speculum from said holder.

3. In a diagnostic instrument for the examination of a body cavity, a speculum holder, an open ended speculum having a substantially U-shaped. body entering portion and a ring shaped portion located rearwardly of said U-shaped portion, said ring shaped portion being rotatably mounted in said speculum holder, said ring shaped portion being formed with an annular channel in its outer wall having teeth on one of the channel sides, and a pinion rotatably mounted in said speculum holder and projecting into said speculum channel for engagement with the teeth thereof, and means located externally of said speculum holder to actuate said pinion and thereby rotate said speculum relative to said holder.

4. In an anoscope, an open ended speculum. having a substantially U-shaped body entering portion and a ring shaped portion located rearwardly of said U shaped portion adjacent the proximal end of the speculum, a holder for said speculum having a ring shaped portion in Which said speculum ring shaped portion is adapted to be telescopically received, an annular channel formed in the outside wall of said speculum ring shaped portion, said channel having teeth formed in one surface thereof, a reciprocable plunger mounted in said holder ring shaped portion having a pinion on the inner end thereof, spring means coacting with said pinion to normally project the pinion into said channel in mesh with said teeth, and means located externally of said speculum holder to rotate said plunger and pinion and thereby rotate said speculum relative to said holder, said plunger and pinion being retractable out of engagement with said channel and teeth against the action of said spring means to permit disassembly of said speculum and holder.

5. In an anoscope including a light carrier and a power source operably connected to said light carrier, an open ended speculum having a sustantially trough shaped body entering portion and a ring shaped portion located rearwardly of said trough shaped portion adjacent the proximal end of the speculum, a holder for said speculum operably connected to said light carrier and having a ring shaped portion in which said speculum ring shaped portion is adapted'to be telescopically and rotatably received, an annular channel formed in the outside wall of said speculum ring shaped portion, said channel having teeth formed in one side wall thereof, a reciprocable plunger extending radially through said holder ring shaped portion and terminating at its inner end in a pinion, spring means coacting with said pinion to normally project it into said speculum channel to maintain said speculum and holder in telescopic engagement, and means on the outer end of said plunger to withdraw said pinion from said channel against the action of said spring means to permit disassembly of said speculum and holder, said pinion being in mesh with said channel teeth when the former is projected into. said channel by said spring means, said withdrawing means on the outer end of said plunger also being operable to rotate the plunger and pinion and thereby rotate said speculum relative to said holder.

6. Structure as defined in claim 5 wherein said speculum ring shaped portion is formed with a flange adjacent the distal side thereof, said flange abutting against the distal edge of said holder ring shaped portion when the two portions are telescopically assembled.

7. In a diagnostic instrumentfor the examination of a body cavity, a speculum holder, an open ended speculum having a substantially U-shaped cavity entering portion and a ring shaped portion located rearwardly of said U-shaped portion, said ring'shaped portion being supported by said speculum holder and being formed with an annular rack, and means to normally maintain said speculum and holder in assembled relation comprising a spring biased plunger on the holder projecting into engagement with the speculum, Lsaid plunger being retractable out of engagement with said speculum to enable same to be separated from said holder, said plunger having a pinion at its inner end in mesh with said rack when the speculum and holder are in assembled relation whereby rotation of said plunger operates to rotate said speculum relative to said holder.

References Cited in the file of this patent UNITED STATES PATENTS Ingersoll Mar. 17, Both J an. 9, Fossati Jan. 29, Rubens et a1. Feb. 5, Abramson Nov. 6,

FOREIGN PATENTS Austria Sept. 10, 

